Kornimate/medical-research-clean huggingface dataset:
nurse-led pain management in adult icu

Conditions: Pain Management

Summary: this project is about implementing a pain scale, the critical care pain observation tool (cpot), in icu settings at king abdullah medical city to evaluate its impact on nurse pain assessment and management. pain is considered as a significant problem in icu and the literature shows that 50% of patients in icu suffer moderate to severe pain and up to 70% of patients experience undetected pain while in icu. the cpot is an evidence-based intervention to assess pain among non-verbal patients in icu settings. a stepped-wedge randomised trial will be used to implement the cpot in 8 icu in king abduullah medical city. patient chart audits and a survey of icu nurses will be conducted post implementation.

this project is about implementing a pain scale, critical care pain observation tool (cpot), in 8 adult icus in king abdullah medical city to evaluate the impact on nurse pain assessment and management. the literature shows that pain is perceived to be one of the most concerning issues in icu and that 50% of patients in the icu suffer moderate to severe pain. in addition, 70% of patients have undetected pain while admitted to icu. evidence-based guidelines suggest that cpot is the most reliable and efficient pain scale tool for non-verbal patients in icus, and it is recommended in countries such as the usa, canada, australia and new zealand. the literature suggests that cpot has a positive impact on frequency of pain assessment. a stepped-wedge randomised trial will be used to implement the cpot and at the same time assess the effectiveness of cpot on pain assessment frequency and management. patient charts will be audited, and a survey of nurses will be undertaken post cpot implementation to assess the cpot acceptability, appropriateness and feasibility.

Eligibility criteria:
patient chart audits inclusion criteria: * patient's who are 18 years and above * patients must be discharged from icu exclusion criteria: - patient's who are on muscle relaxants nurses survey inclusion criteria * working in icu * understand english language

Keywords: pain icu critical care nurses pain assessment cpot
daptomycin > 6 mg/kg/day as salvage therapy in patients with complex bone and joint infection: cohort study in a regionalreference center

Conditions: Bone and Joint Infection; Treated by Daptomycin

Summary: the choice of antimicrobial therapy to treat complex bone and joint infections (bji) is challenging, requiring consideration of: (i) the problem of bone diffusion; (ii) the necessity of using antimicrobials active against bacterial biofilms; (iii) the growing incidence of antibiotic resistance; and (iv) the high risk of severe adverse events (sae) in response to first-line antimicrobials in these patients. consequently, off-label use of recently developed antimicrobials, such as daptomycin, is frequently required as salvage therapy in complex bji. even if daptomycin does not have approval for the treatment of bji, the infectious diseases society of america guidelines propose this antibiotic as alternative therapy for prosthetic joint infection. the recommended dose is 6 mg/kg/d, whereas recent data support the use of higher doses in these patients as bone penetration of daptomycin is limited. the present cohort study aimed to assess the safety and efficacy of prolonged high-dose (\>6 mg/kg/d) daptomycin salvage therapy in patients with complex bji.


Eligibility criteria:
inclusion criteria: * patients having bji treated by daptomycin at \>6 mg/kg/d exclusion criteria: -

Keywords: bone and joint infection daptomycin eosinophilic pneumonia
assessing the benefit of art & music therapy on quality of life in patients with breast cancer

Conditions: Breast Cancer

Summary: this is a study of art-based and music-based therapy programs lasting three months (with additional follow-up 3 months after the end of the trial) in breast cancer patients currently receiving therapy as well as in cancer survivors.

a cancer diagnosis is often associated with adverse psychosocial effects, including: increased stress and anxiety, fatigue and sleep disturbance, impaired memory and cognition, and poor quality of life. chemotherapy can cause a cognitive decline in up to 75% of patients; an impairment that oftentimes persists beyond completion of the regimen. this is known as "chemobrain". integrative therapies are actively being investigated to help improve psychological wellbeing among cancer patients and survivors. the current standard at this institution is to inform patients of different complementary services that are available, including art therapy, music therapy or acupuncture, but not require patients to use them. participants in this study will be randomized to one of three arms 1) art therapy program, 2) music therapy program, or 3) standard of care (soc). in-person and at-home therapy sessions will be scheduled in alternating, weekly sessions, to allow one week of self-reflection and remote therapy between in-person sessions. each participant will be asked to attend two in-person therapy sessions per month (total of 6). the primary objective of this study is to determine the efficacy of a 3-month, therapist-led art or music therapy program to improve quality of life in breast cancer patients currently receiving therapy and in cancer survivors. secondary objectives of this study are: to determine the effect of these programs on patient cognition in this population. to determine the effect of these programs symptoms of anxiety and depression in this population. to assess whether the effect of these programs is sustained at a 3-month follow-up.

Eligibility criteria:
inclusion criteria: * breast cancer diagnosis (stage 0-iii) * treated at cleveland clinic by medical oncologist, radiation oncologist, and/or breast surgeon patients currently undergoing treatment or have completed active treatment (surgery, radiation or chemotherapy) within past 5 years. * able and willing to participate in art or music therapy programs at maroone cancer center * subjects must have the ability to understand and the willingness to sign a written informed consent document * ability to read and write in english * performance status 0 or 1 as per ecog scale exclusion criteria: * no prior history of breast cancer * history of metastatic disease (stage iv) * not being followed by medical oncologist, radiation oncologist, and/or breast surgeon at cleveland clinic * unable or unwilling to participate in art or music therapy program at maroone cancer center

Keywords: cancer survivors music therapy art therapy
treatment of spinal cord injuries with (autobm-mscs)vs (wj-mscs).

Conditions: Spinal Cord Injuries

Summary: this study aims to assess and compare the safety and effectiveness of autologous bone marrow-derived mscs (autobm-mscs) in one group(group a) of sci who are unlikely to be able to walk independently without treatment after 1 year of sci, in the other group (group b) to assess the second group of wharton jelly derived mesenchymal stem cells ( wj-mscs) in the treatment of acute and subacute spinal cord injury (sci) patients.

the study will be directed by the cell therapy center (ctc) in jordan, where 20 sci patients meeting the inclusion criteria will be recruited and divided according to the type of injury into two groups; group a for patients with complete transection of the spinal cord, and group b for sci without a total transaction,10 patients will receive (autobm-mscs)and the other 10 patients with acute and subacute spinal cord injury will receive(wj-mscs) by a specialized spine surgeon into the spinal medulla. the outcomes and improvements will be assessed using the american spinal injury association (asia) impairment scale (ais) and the spinal cord independence measure (scim) version iii, in addition to blood tests, mri, and somatosensory evoked potential (ssep).

Eligibility criteria:
inclusion criteria: * age: 18-70 years * complete sci grade ais-a or -b, or incomplete c * sci between cervical levels c5 and thoracic level t11 * at least 12 weeks since time of injury * prediction rule score of 10 or less * cognitively unaffected * motivated for stem cell transplantation exclusion criteria: * reduced cognition * age under 18 years or above 70 years * significant osteoporosis in spine and/or joints * pregnancy (adequate contraceptive use is required for women in fertile age) * anoxic brain injury * neurodegenerative diseases * evidence of meningitis * positive serology for hiv, hbv, hcv, or syphilis. * medical complications that contraindicate surgery, including major respiratory complications. * use of metal implants close to vascular structures (such as cardiac pacemaker or prosthesis) that contraindicate mri. * other medical conditions which can interfere with stem cell transplantation * inability to provide informed consent. * uncorrected vision * cardiac abnormalities and uncontrolled hypertension

Keywords: spinal cord injuries mesenchymal stem cells allogenic bone marrow derived mesenchymal stem cells american spinal injury association impairment scale
finger individuation training with a training device versus conventional rehabilitation for writer's cramp

Conditions: Dystonic Disorders

Summary: writer's cramp (wc) is a focal dystonia characterized by abnormal movements and postures during writing. limited finger independence during writing manifests as difficulty suppressing unwanted activations of neighbouring non task-relevant fingers. wc patients also have difficulty in fine control of grip force. however, some previous studies indicate positive effects of individual finger movement training in wc although these studies lacked enhanced visual feedback of activations in 'stationary' fingers. the investigators have recently developed the finger force manipulandum which quantifies the forces applied by the fingers in different tasks. this method is sensitive for detection and quantification of small unwanted contractions in non-active ('stationary') fingers. forces in 'stationary' fingers can be displayed on-line providing enhanced feedback on independence of finger movements. the aim of this study is to test the effectiveness of finger individuation training using the ffm to improve symptoms in wc patients.


Eligibility criteria:
inclusion criteria: * writer's cramp (diagnostic confirmed by a neurologist specialized in movement disorders * handwriting speed \< 140 letters per minute * simple or complex writer's cramp * scholarship in french language * absence of treatment by botulinum neurotoxin, or last injection \> 3 months * age \> 18 and \< 71 years * informed consent * medical insurance coverage exclusion criteria: * writer's cramp with no impact on writing * writing tremor * other neurological disease with effect on writing * pain or traumatism of the limb used for writing, requiring medical or surgical treatment in the last preceding months * participation in another research with a potential impact on evaluation criteria * pregnant or breast feeding patient * patient under judiciary protection

Keywords: focal dystonia writer's cramp
utilization of the tad device for dispensing pain medications in hospice patients

Conditions: Medication Adherence; Satisfaction, Personal

Summary: a novel device, tad, has been developed to aid adherence to prescribed regimens and may have a roll in hospice pain management. this study aims to assess medication adherence relating to missed doses or improperly timed doses with and without the aid of a mobile device as a primary endpoint. secondary endpoints will be patient, nursing, and provider satisfaction.

this study is a randomized crossover study in which patients will be randomized to start with or without a mobile device assisting the patient or caregiver in using the device. the investigators aim to enroll 20 patients across 3 sites. each patient is expected to participate in the study for 12 weeks. after the first 2 weeks of participation, the patient will either begin using the mobile device to assist or will stop using the mobile device for the next 2 weeks. after the initial 4 weeks, the patient will choose to continue with or without using the mobile device.

Eligibility criteria:
inclusion criteria: * any patient taking morphine er or oxycontin on one of three hospice home teams exclusion criteria: * pregnancy * inability to demonstrate competent use of the device * age less than 18
safety and efficacy of gintuit(tm)for oral soft tissue regeneration

Conditions: Gingival Recession

Summary: the purpose of this study is to evaluate gintuit as a safe and effective alternative to palatal tissue in the treatment of subjects (with recession-type defects) who have an insufficient zone of attached gingiva associated with at least two nonadjacent teeth.


Eligibility criteria:
inclusion criteria: * subject is at least 18 years of age but no more than 70 years of age. * subject has at least two non-adjacent teeth in contralateral quadrants of the same jaw with an insufficient zone (\< or = 1mm) of attached gingiva that requires soft tissue grafting. (1-3 teeth may be treated. in case of adjacent teeth requiring grafting, only one tooth at each site will act as test or control tooth, but all teeth will get the same treatment). * root coverage is not desired at the time of grafting. * females of childbearing potential must have a documented negative urine pregnancy test. * subjects must have read, understood and signed an institutional review board (irb) approved informed consent form. * subjects must be able and willing to follow study procedures and instructions. exclusion criteria: * subject with class iii recession in the presence of a shallow vestibule or class iv recession. * subject with vestibule depth of less than 7mm from base of recession. * subject with any systemic conditions that could compromise wound healing and preclude periodontal surgery (i.e., diabetes mellitus, cancer, human immunodeficiency virus (hiv), bone metabolic diseases). * subject who is currently receiving or has received within two months prior to study entry, systemic corticosteroids, immunosuppressive agents, radiation therapy, and/or chemotherapy which could compromise wound healing and preclude periodontal surgery. * subject with the presence of acute infectious lesions in the areas intended for surgery. * subject who has used any tobacco product within 3 months. * subject who is taking intramuscular or intravenous bisphosphonates. * subject with only molar teeth suitable for soft tissue grafting. * subject with teeth that have miller grade 2 or higher mobility. * subject with known hypersensitivity to bovine collagen and/or iodine (shellfish allergy). * subject who has received an investigational drug or biological/bioactive treatment within 30 days prior to study enrollment (medical or dental). * subject who was previously treated with gintuit, dermagraft or any other skin graft at the target site(s) or immediately adjacent teeth. * subject, who in the opinion of the investigator, for any reason other than those listed above, will not be able to complete the study per protocol.
shock wave therapy for lower limb lymphedema

Conditions: Lymphedema, Lower Limb

Summary: this is a double-blind randomized clinical trial to compare the effect of shock wave therapy on lower limb lymphedema. there are two arms: a) complex decongestive therapy + extracorporeal shock waves therapy; b) complex decongestive therapy plus placebo extracorporeal shock waves.

this is a double blind, randomized, clinical trial. 30 patients with lower limb lymphedema will be randomized in 2 groups. one group will receive the habitual complex decongestive therapy (lymphatic manual drainage and compression) plus extracorporeal shock waves therapy. the other group will receive complex decongestive therapy (lymphatic manual drainage and compression) plus placebo extracorporeal shock waves. patients in the 2 groups will be instructed on skin care measures and kinesitherapy. the usual manual lymphatic drainage and compression will be applied to the 2 groups. the 2 groups will receive 10 treatment sessions, 2 weekly for 5 weeks. group complex decongestive therapy + shock waves. patients will receive treatment with manual lymphatic drainage, compression, and shock waves. group complex decongestant therapy + placebo. patients will receive treatment with manual lymphatic drainage, compression, and placebo shock waves. tolerance and possible adverse effects will be recorded by physiotherapist. any adverse effect detected will be evaluated by the rehabilitation medical doctor.

Eligibility criteria:
inclusion criteria * patients with lower limb lymphedema * lymphedema of at least 6 months of evolution * the lymphedema must affect at least the knee to the foot * moderate or severe lymphedema (grades 2 or 3) * sign the informed consent exclusion criteria * under 18 years of age * coagulation disorders (hemophilia, treatment with acenocoumarol, etc.) * current or previous deep vein thrombosis of the lower extremity * pregnancy * electronic implantable medical devices as pacemaker implants, medication pumps, etc * having received treatment with complex decongestive therapy or shock waves during the last 6 months * treatment with corticosteroids or radiotherapy in the area to be treated in the last 6 weeks * active oncological disease in the area to be treated * active infectious-inflammatory process in the area to be treated * cognitive or sensory deficits that prevent collaboration * inability to walk independently or inability to attend therapy
integrated care for migraine and chronic tension-type headaches

Conditions: Chronic Headache

Summary: chronic headache is among the most common neurological disorders with major physical, psychological, social and economic impact. the aim of this prospective observational study isto investigate the effects of an interdisciplinary multimodal integrated care program in patients with chronic migraine and/or tension-type headache. 158 patients with chronic migraine or tensions-type headache at least five days per month for at least 6 months and current intake of triptans (migraine) or analgesic drugs (tension-type headache) are eligible. patients undergo inpatient, outpatient and/or semi-stationary treatment including conventional headache diagnostics and therapy as well as traditional chinese medicine, european naturopathy, and mind-body-medicine approaches. headache frequency is defined as the primary outcome; secondary outcomes include pain (visual analog scale, pain perception scale), triptans and analgesics use (headache diary), health-related quality of life (sf-36), function (headache disability inventory, patient-specific functional scale), depression and anxiety (hospital anxiety and depression scale), and pain self-efficacy (pain self-efficacy questionnaire). outcomes are assessed at treatment start, treatment end and 6 months after treatment end.

chronic headache is among the most common neurological disorders with major physical, psychological, social and economic impact. the aim of this prospective observational study isto investigate the effects of an interdisciplinary multimodal integrated care program in patients with chronic migraine and/or tension-type headache. 158 patients with chronic migraine or tensions-type headache at least five days per month for at least 6 months and current intake of triptans (migraine) or analgesic drugs (tension-type headache) are eligible. patients undergo inpatient, outpatient and/or semi-stationary treatment including conventional headache diagnostics and therapy as well as traditional chinese medicine, european naturopathy, and mind-body-medicine approaches. headache frequency is defined as the primary outcome; secondary outcomes include pain (visual analog scale, pain perception scale), triptans and analgesics use (headache diary), health-related quality of life (sf-36), function (headache disability inventory, patient-specific functional scale), depression and anxiety (hospital anxiety and depression scale), and pain self-efficacy (pain self-efficacy questionnaire). outcomes are assessed at treatment start, treatment end and 6 months after treatment end.

Eligibility criteria:
inclusion criteria: headache at least five days per month for at least 6 months current intake of a) at least 10 triptans per month or b) analgesic drugs that can themselves elicit headache exclusion criteria: none.
cardiac autonomic denervation for cardio-inhibitory syncope

Conditions: Bradycardia; Syncope; Syncope, Vasovagal

Summary: background: autonomic system modification is an established therapeutic approach that has been increasingly used for the treatment of vagal-related symptomatic bradycardia, such as cardio-inhibitory vasovagal syncope1-12. although convincing results had been reported from small populations, a large randomized study providing robust evidence on the efficacy of this approach has not yet been performed. hypothesis: cardiac autonomic system modification is effective for the treatment of vagal-related symptomatic bradycardia, and is associated better clinical results as compared to placebo.


Eligibility criteria:
inclusion criteria: * aged between 18 and 70 years old. * cardio-inhibitory response (vasis 2a or 2b) during tilt test, or after carotid sinus massage. * patients with bradycardia mediated by vagal hypertonia documented on 24-hour holter monitoring and a clear relationship with symptoms. exclusion criteria: * ages under 18 and over 70 * presence of structural heart disease documented by echocardiography. * hypothyroidism and hyperthyroidism, drug effects, obstructive sleep apnea and other causes of secondary bradycardia. * anatomical disease of the conduction system.

Keywords: cardiac denervation cardio-inhibitory syncope
cardiac dysfunction in critically ill patients with covid-19

Conditions: Covid19; Left Ventricular Dysfunction; Right Ventricular Dysfunction; Pulmonary Hypertension

Summary: cardiac dysfunction has been reported to be common in patients infected with covid-19. the aim of this study is to evaluate the clinical importance of cardiac dysfunction in critically ill patients infected with covid-19.

cardiac dysfunction has been reported to be common in patients infected with covid-19. the aim of this study is to evaluate the clinical importance of cardiac dysfunction in critically ill patients with covid-19. patients admitted to the intensive care unit, with covid-19 are examined with echocardiography for assessment of left and right ventricular dysfunction within 72 hours from admission and repeated after four to seven days. cardiac dysfunction was defined as having either left ventricular (lv) dysfunction, defined as having an ejection fraction \<50% and/or regional hypokinesia, or right ventricular (rv) dysfunction, defined as having a tricuspid annular plane excursion (tapse) \<17mm or a moderate/severe rv dysfunction assessed visually. the cardiac biomarkers troponin and ntprobnp and clinical data are recorded at time of each echo. mortality status is recorded at 30 days.

Eligibility criteria:
inclusion criteria: patients admitted to the intensive care unit infected with covid-19 exclusion criteria: -